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PROTOCOL FOR SPONGE BATH

Purpose​

Making sure all babies maintain proper hygiene. To observe the skin, umbilical cord, temperature and respiration pattern. Prevention of infections.

Procedure​

  • Preferably wash the baby when awake, before feeding and with the support of a parent. If a parent is not available, two nurses should be present when washing sick and/or preterm babies. Ideally parents/relatives should perform the daily washing under supervision and guidance from the nursing staff.
  • Have all necessary equipment in close reach before washing:
    • Thermometer, diaper, linen, new nest and cotton
    • Clean, warm water without soap
    • Dextrose 10 %
    • Suctioning catheters
    • Gloves
  • Make sure the baby is stable enough to be washed. If in doubt, ask the doctor on call.
  • During the washing, observe the umbilical cord, and look for signs of infection, e.g. redness, swelling, and discharge. Inform the doctor if an infection is suspected. Observe the skin for trauma, for disruption of normal barrier function, rashes, colour and maturity.
  • Start with:
    • Clean hands.
    • Evaluate the respiratory pattern. Is the baby in respiratory distress, use accessory muscles, is grunting or have nasal flaring? How is the respiratory rate?
    • Measure the baby’s temperature. If the baby is hypothermic, the wash cannot continue.
    • If suctioning is required, use gloves.
    • Gently remove unnecessary tape while administering 10 % Dextrose for pain relief. Oil can be used to make the removal of the tape less painful, but do not use oil if the baby is in phototherapy.
  • Begin with the face and wash downwards towards the feet. Wash the diaper area at last.
    • Use different part of the cotton for each eyeball. Wash from nose towards ear to prevent passing of bacteria’s from one eye to the other.
    • Make sure to get rid of all secretion around the mouth.
    • Wash ears, behind ears, neck, underarms, feet and obvious soiled body parts.
    • Last, wash the diaper area using gloves (if stool). Always wash from the front to the back.
    • To keep the umbilical cord dry, fold the diaper below the level of the stump.
    • Dry the baby by gently patting, do not rub.
  • Weigh the baby if possible and place the baby in a clean bed/nest.
  • IMPORTANT: Change the position of the SaO2 sensor. To reduce the risk of pressure marks and sores to develop, cotton can be placed between the probe and the baby`s skin.
  • Clean your hands.

Give the baby a break or stop the wash entirely if the baby becomes stressed, cyanotic, drops in saturation or heart rate, or have apnoea. Never disconnect the ventilator during washing or changing of linen.

References​

Oslo University Hospital Procedure on Washing a Baby in Incubator (2014), Practical Procedures for the Newborn Nursery, A Manual for Physicians & Nurses, by Deorari, Paul, Singhal, Scotland and McMillan, Third Edition (2010), Neonatal Intensive Care by Merenstein & Gardner, 7 edition (2011) and Comprehensive Neonatal Nursing Care, by Kenner and Lott, fifth edition (2014).

Document Information​

Archived Version

Version: 1.0 (Archived)
Published: August 3, 2015
Contributors: Teaching Nurses from Norway and FBNCU Nursing Staff, JK Lone Hospital, SMS Medical College, Jaipur
View: Current Version